Global Spine J 2014; 04(03): 157-160
DOI: 10.1055/s-0034-1378142
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Ambulatory Spine Surgery: A Survey Study

Evan O. Baird1, Sasha C. Brietzke2, Alan D. Weinberg2, Steven J. McAnany1, Sheeraz A. Qureshi1, Samuel K. Cho1, Andrew C. Hecht1
  • 1Department of Orthopaedics, Mount Sinai School of Medicine, New York, New York, United States
  • 2Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, New York, United States
Further Information

Publication History

24 March 2014

29 April 2014

Publication Date:
09 June 2014 (eFirst)

Abstract

Study Design Cross-sectional study.

Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States.

Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value < 0.25 were entered into a multiple logistic regression model. All statistical analyses were performed using the SAS System software Version 9.2 (SAS Institute, Inc., Cary, North Carolina, United States).

Results Overall, 84.2% of respondents performed some manner of ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039).

Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety.